Book reviews

The sudden resurgence of interest in the pre-Columbian Norse voyages to the mainland of North America has made this book a publication of more than ordinary interest and importance. Considering the ridiculous "controversy" concerning the priority of discovery of America stimulated by the publication of Yale's Vinland Map, it is vital that the public be offered what are truly the "grass roots" of the matter. First published in 1965, the book has now been reissued with a note referring to the newly discovered cartographic evidence of the Norse landfalls. In addition to the excellent translations of the GRAENLENDINGA and EIRIK Sagas—the basic stories of the Vinland voyages—the book contains a first rate analytical introduction and an explanatory note on the translations themselves. Both of these are of inestimable value to an uninformed reader making contact with the Sagas for the first time. The authors are to be complimented on their balanced appraisal of the background of the voyages and the genesis of the Sagas. They also touch on the fascinating and frustrating "question mark" as to whether or not Christopher Columbus knew of the Norse voyagers before his own "Enterprise of the Indies." Speculation as to the exact location of Vinland will go on and on until concrete and unassailable archaeological evidence proves conclusively where the site might be. Possibly the recent excavations of Dr. Helge Ingstad and his archaeologist wife in Newfoundland will prove to be Vinland, but this must await the publication of the scientific report on this fascinating discovery. The authors remain sceptical that the Ingstad dig is specifically Vinland as it "is inconsistent with the sagas at one crucial point—the grapes that gave Vinland its name; for wild grapes, it is believed, have never grown farther north than Passamaquoddy Bay, between Maine and New Brunswick. This automatically disqualifies Newfoundland as the location of Vinland and no amount of philological juggling with the name . . . can wish this away." This statement is based, as the authors say, on "the Sagas themselves where the name of the country is explicitly associated with its wine." Readers of this book will be particularly impressed by the Sagas themselves and the exciting, bloody, and dramatic adventures of the participants


MR.
WILSON is one of those men who reflcct honour on the medical profession in England, and who have raised the character of a considerable portion of the English practitioners above those of any other nation in Europe, for intellectual, practical, and moral qualifications. The friends of surgery, and those of Mr. Wilson himself, had long regretted that a man so eminentty gifted with talent, tact, and dexterity in his profession,?one whose long practical career had entitled him to take the lead among didactic authors, should not have consecratcd a portion of his valuable hours to give permanency to the fruit of his professional experience, by transmitting it to posterity through the press. This regret has now ceased. Mr. Wilson's opinions, and the result of his meditations and of his practice, are before the public. After having served, orally, the commendable purpose of promoting a real taste for surgery among the students and junior members of the profession, who throng annually to the Royal College in Lincoln's-Inn-Fields fpr information, and whose zeal and emulation must have been thus excited, Mr. Wilson's opinions and practical results at e, at last, committed to the world at large, to be judged?not by the author's * Our Subscribers, and the Profession in general, may be supplied with any of the Foreign or English Publications noticed or reviewed in (his Journal, on the shortest notice, by addressing a line to J. Souter, 73, St. Paul's Churchyard; by whom this Journal is regularly delivered to the Subscribers on tliv first of every month. traditionary reputation, but by their real and intrinsic value . nor need he fear the result of that judgment.
Mr. Wilson has published three series of Lectures in a short space of time; and we have selected the third for our consideration, because, as it treats of diseases affecting the structure of very important parts of the human fabric, " it is for the true happiness and real interests of mankind," as the author himself properly observes, " that they should be repeatedly investigated, and, as far as possible, divested of all that mystery with which ignorance and quackery have in many instances endeavoured to envelop them." The volume now before us consists of fifteen lectures; six of which treat of subjects strictly anatomical, and the remainder relate to the physiology of functions performed by the organs under consideration, and to the diseases incidental to those functions, or to the organs themselves. By far the larger portion of the contents of the volume is consecrated to the history of calculous disorders,?a subject which has been so often, and so recently, handled by various writers, that we should have felt some surprise at Mr. Wilson's entering on such an inquiry, had we not been aware that, as a lecturer, it was his duty to lay before his audience a complete delineation of those diseases, certainly not the least in importance in the history of the morbid affections of the urinary Organs.
Healthy Urine; Morbid Urine; Nature of the Glands secreting that Fluid. (Lecture i.)?After a few introductory observations, in which the author details his reasons for choosing the structure and diseases of the urinary and genital organs for the subjects of his lectures, Mr. Wilson proceeds to enumerate the characters of healthy urine, taken chiefly from the writings of Wollaston, Bostock, Brande, Marcet, Prout, and Berzelius; to which he refers his readers for a more ample account of the experiments by which the composition of this most heterogeneous fluid has become known. This subject has been so lately discussed in this Journal, while reviewing Dr. Prout's work, that we shall not detain our readers upon it. What must interest most medical men, are the prominent characteristics of urine secreted under the influence of disease; which information they will find detailed in Mr. Wilson's book, as he derived it from Professor Brande. The internal anatomy of the kidney gives Mr. Wilson an opportunity of entering into the subject ot the variety in the shape of that organ in different animals; and of mentioning the de-viations which occur in man, from the natural configuration, position, and number, of those secreting glands. 478 Critical Analysis. "The kidney is, however, capable of variation in shape in different animals. It is generally oblong: in fish it is so, and is very narrow; but in some other animals it is almost globular, as in the leopard. In certain animals, in every period of life, the whole mass of kidney is lobulated; in others, the outward surface is always uniform aud smooth. u In the alligator, the surface of the kidney seems to be thrown into processes not dissimilar in appearance to the circumvolutions of the brain. " Kidneys arc found in all quadrupeds, in most animals of cold blood, and in birds and fishes; but there arc some animals in which they have not been found, such as worms and many insects. It is probable that the intestines of such animals perform also the office of kidneys.
" In all animals which possess kidneys, the number in each animal has never been found to exceed two. From the fish upwards, they arc in pairs; but below fish, as in the sepia, snail, &c. there appears to be only one kidney.
\ " In the human body, the lower extremities of each kidney are sometimes found to have incurvated inwards, to have passed before the aorta aud vena cava, aud to have become firmly united to each other. This deviation from the natural form has been called, from its shape, a horse-shoe kidney. In cases of this kind, a distinct pelvis is generally found on each side, from which the ureter descends and pursues its usual course. I have met with one instance only of a single kidney; and, as it was taken from a child not exceeding two years of age, it still preserved the lobulated appearance of a kidney in early life, but was more than double the size of one of that age. There was no vestige of a kidney on the opposite side: the kidney alluded to had, therefore, to perform the office of two, which accounted for the enlargement. In structure it appeared to be healthy and natural." The following jiractical observations with regard to the contiguity of other organs to the kidney in the human body, should be kept fresh in mind by the junior practitioners. 4< The upper extremity of cacli kidney lies before, and is in contact with, a portion of the diaphragm which is attached to the lower rib; the pressure of which muscle produces the pain felt in respiration when the kidney is highly inflamed. The kidney of the left side extends farther upwards than that of the right, and is therefore generally found to be the longest; for the lower extremity of each kidney is placed as nearly as possible on the same level,?viz. that of the inside of the spine of the ileum. This difference in length may arise from the more constant pressure made on the right kidney by the liver, which is a viscus not subjected, while in a healthy state, to any great alteration in size ; whereas the kidney of the left side has, above and before it, viscera less solid in structure, and whose size is subjected to constant changcs, as the stomach, the spleen, though in a less degree, and the, colon." There is a clear simplicity in the detailing of the arrangement of tiie arteries in the kidney, which merits being recorded. " The vessels belonging to the human kidney enter at the concavity on its inner and anterior edge. The renal or emulgent arteries arise from the sides of the aorta, a short distance below the origin of the superior mesenteric artery: the right emulgent is frequently rather the lowest of the two; it is also the longest, as it has to cross behind the vena cava inferior to reach its destination. Each artery divides into several branches, which enter the kidney separately, and without previously anastomosing with each other. Sometimes two, three, or niore arteries, shall come off separately from the aorta at first, and procecd directly to enter the kidney: I have in one instance seen six enter the same gland. The arteries which convey blood to the kidney have their coats thicker and stronger, in proportion to the extent of their cavities, than any other arteries in the body." The same observation applies to Mr. Wilson's description of the veins, nerves, and absorbent vessels, of the kidney. His statement of the use and function of this important organ of the animal economy, which John Hunter has emphatically styled the common sewer of the constitution, is also luminous.
Internal Anatomy of the Kidneys; Capsules renales; Ureter; Bladder. (Lecture u.)?The internal structure of the kidney is yet a mystery. Minute injections have been made to trace its vessels in their intricate course and circumvolutions; but there is as much difficulty attending the unravelling of this gland as we experience in studying that of all other glands of the human economy. Mr. Wilson relates the appearances which may be observed in injected kidneys, viewed through magnifying glasses. As to the physiological explanations inferred from the structure so viewed, they can only be considered as surmises. Our author is of opinion that the common phenomena of absorption and circulation are sufficient to account for the rapidity with which certain liquids, taken into the stomach, have passed into the bladder, without supposing the existence of vessels yet undiscovered, which should form an immediate communication between those two viscera without the intervention of the kidneys. Professors Tiedman and L. Gmelin, of Heidelberg, have proved, in a recent work, that the existence of such secret vessels is a chimcra; but they state at the ?aine time that, from the numerous experiments they have made, they feel themselves authorized to think that several substances introduced into the animal economy, pass directly into the vena portarum, and from thence to the heart, &c. without going along the tortuous channels of the lymphatic system.
On the subject of the secretion of urine, we cannot omit mentioning a series of physiological inquiries, by Dr. Krimer* 430 Critical Analysis. professor of clinical medicine in the University of Bonn, in which the important question?" In what organ is urine secreted ?" has been satisfactorily discussed, and the answer to that question is given, founded on the result of seventeen interesting experiments. In one of these, the spleen of a healthy dog having been removed without much inconvenience to the animal, which recovered in five days from the operation, it was ascertained that the organ in question seems to exert no exclusive influence either on the secretion of urine or on the transmission of fluids from the stomach to the vesical organs, as imagined by Sir E. Home and others. From two other experiments, it appears that the gastric veins are the vessels which absorb the substances contained in the stomachy carrying them to the lungs, in the first instance,?thence to the heart.,?and lastly to the kidneys. Prolessor Krimer's memoir is distinguished by so much candour and originality, and the physiologienl points it is intended to elucidate are of so much importance, that we shall take an early opportunity of submitting it to our readers.
The anatomical descriptions of the renal capsul?, the ureter, and the bladder, in Mr. Wilson's book, are clear and concise ; but we cannot stop to analyze them. Genital Organs; Semen; Scrotum; Spermatic Chord; Testicles. (Lecture in.)?Having traced the urine from its formation in the kidneys to its lodgment in the bladder, and having detailed the structure of the parts individually employed in carrying on those operations, Mr. Wilson proceeds to follow a similar course with respect to another equally important question,?the secretion or formation of semen,?and gives a clear description of the organs destined to that operation, as well as of those intended to transmit that fluid for the purpose of reproduction.
The urethra being the common outlet to both fluids from the body, is very properly described last.
Mr. Wilson's preliminary observations on generation did not appear to us to be well placed in a book of this kind ; and, as there is nothing, but what is hypothetical, to be said on the subject, the audience at the College, and his readers, might have been saved the waste of time which the perusal of, or the listening to, theoretical suppositions must evidently occasion. There are, however, many curious facts in this part of the third lecture which will compensate for the trouble of reading it; but nothing beyond compilation will be found in it. Mr. Wilson iias the merit, however, of being very short on the subject.
In speaking of the structure of the scrotum, Mr. Wilson observes, that, till very recently, he had not been able to trace distinctly the dartos muscle, so minutely described by Winslow,481 by which that sac is endowed with the power of oblique motion, and of corrugation when cold is applied. '' In a dissection made by the late Mr. Henry Ilorne, of Newcastle, in Windmill-street, at the time when he was'my house-pupil, I saw many red and fleshy fibres attached by tendinous expansions to the part of the perineum where the acccleratores urina;, transversi perinaei, and sphincter ani muscles, are connectcd with each other: these fibres, from this attachment, divided into three portions, which expanded themselves on the inner surface of the skin of the scrotum,? two running laterally towards the groins, and one taking a middle direction near the raphe. Mr. Daw, then house-surgeon to St.
George's Hospital, made an accurate drawing of the appearances,? that which I have now the satisfaction of producing. Since then I have repeatedly traced, but not with the same distinctness as to colour or thickness of the packets, a similar muscular distribution and tendinous attachments." The description of the cremaster muscle, the tunica vaginalis, the epididymis, and of the spermatic chord, will be read by the students of anatomy with advantage and satisfaction.
Secretion.?Structure, first Formation, and Descent, of the Testicles in the Scrotum. (Lecture iv.)?The first of these points is quickly dispatched; and the author wisely concludes with the following assertion: ie Many theories have been entertained on secretion, founded on. the peculiar structure of the different glands : some of these have been ingenious, and others very evidently absurd. At this moment it is not known how secretion is actually performed in any one gland.' With regard to the second point treated of in the present lec ture, we wish we had space to quote every line of our author's description : it will be found to be clear and satisfactory.
The descent of the testicle into the scrotum is still involved in much difficulty. The discovery of Dr. W. Hunter, that the testicles lay in the cavity of the abdomen until the approach of birth; and the subsequent investigations of his brother, who made out that the testicles are formed in the cavity of the abdomen ; are known, wre presume, to all our readers. Mr.
Wilson adopts this view of the question, and proceeds to describe what he conceives to be the general mode of lying of the testicles in the abdomen in the fetus, up to the sixth month, ^vhen thev are said to move towards the ring, the innei orifice ?f which they usually reach about the seventh month. From this period to the ninth, they pass through the ring ; so that, before birth, they are generally found in the upper pait of the scrotum, from whence they descend farther to their ultimate destination. The descent is not sudden, but very gradual: the gubernaculum passes through the ring first, as if to make loom no. ?73. 3 q 4S2 Critical Analysis. and direct the passage of the testes. We have heard the trirtfr of this theory disputed by one of the most eminent surgeons oi the day in this capital; but. we forbear stating the grounds of his doubts, as he has not authorized us to publish them. The whole question, in fact, of the descent of the testicle, with the minute anatomical knowledge 'required to understand it, is one of the greatest interest and importance, not only with regard to mere physiology, but in as far as it bears upon some of the principal diseases and operations in the immediate department of surgery. Considering the present state of our knowledge in this respect, we do not hesitate to say that Mr. Wilson has handled this part of his subject in a masterly manner.* Seminal Vesicles; Prostate Gland; Cowpers Glands. (Lecturcv.) -?" In men, the vcsiculas seminalcs form two oblong bags, situated behind and below the bladder, between that viscus and the rectum, ia the space to which the peritoneal covering of these two viscera docs not extend. They are surrounded by cellular membrane, and more intimately connected by that substance to the bladder than to any other part. Like to the terminations of the vasa deferentia, to whose external lateral edge they adhere, their anterior surfaces arc concave, adapted to the bladder, and their posterior convex, adapted to the hollow sweep on the fore part of the rectum. Their position is oblique; for their lower extremities are separated only by the vasa deferentia, while their upper extremities are placed at a considerable distance from each other on the sides of the bladder. They are rounder and broader at their upper extremities than at their lower; their breadth, at the widest part, is generally three or four times less than their length, and their thickness is about one-third of their breadth, but they gradually become less broad as they approach the cervix of the bladder. The size of the vesicular varies in different men, but this variation docs not seem to depend upon bodily height; for, in some men of short stature, they are in every respect larger than in others who arc tall." Their external surface is uneven. They have two distinct coats, and arc abundantly supplied with arteries from the same trunks which supply the bladder: neither arc they deficient in veins, absorbents, or nervous filaments.
John Hunter docs not consider these bags as reservoirs for semen, but as glands secreting their own peculiar fluid ; and as, by adopting this theory, he does away with the possibility of semen being kept in reservoirs ready for the purpose of re-production, he has imagined that semen Is secreted at the * On the very day following that 011 which this Review was written, we had occasion to see a poor woman who had laid-in, in Kings-head Court, Broadway, Westminster, of three boys, still-born, at six months. The testicles, in each of thorn, were found in the scrotum !! A.B.G. 4S3 time, in consequence of certain affections of the mind stimulating the testicles to this action. Mr. Wilson details the facts Upon "which Hunter founded his particular views of this subject, taken from the human economy, as well as from comparative anatomy; but he at the same time contends, that neither those facts, nor that great physiologist's strong reasoning upon them, afford a demonstrative or conclusive proof, that, in the human subject, the semen may not pass into the vesiculte from the vasa defcrentia. The reasons adduced by our author for entertaining a different opinion from John Hunter are strong, <*nd apparently conclusive; but, such is the candour of Mr.
Wilson, (a qualification, indeed, which distinguishes him throughout his work,) that, although he cannot draw exactly the same conclusions with Hunter as to the impossibility of the vesiculse receiving semen-in the human body, he thinks it his duty to mention a fact which makes in favour of that physiologist's opinion of the vesicula? seminales secreting their own niucus, and which has come within his (the author's) immediate knowledge.
" Several years ago, I was consulted by a respectable tradesman, who had been married only a few months, and whose testicles were much diseased. Mr. Clinc met me in consultation on his ease. As both of the tcsticles and greater part of the scrotum were in a state of cancerous ulceration, and the chord much thickened, we could not Propose the operation of extirpating the diseased parts: soothing Cleans and a palliative treatment were therefore recommended. The patient, however, from the excessive pain which he suffered, was most importunate to have the testicles removed. Having explained to liirn ai*d his relaliyes the small chanccs there were of the wounds healing, I at last complied with his most urgent request, and ventured to extirpate the diseased parts. 1 was much surprised to find that the wounds cicatrized in a little more than a month, and that no recurrence of the disease, in the spacc of the two years that he suryived the operation, took place. His health for some time rapidly amended ; but his pccu<liar situation as a married man preyed on his mind, and, to smother tlie feelings it excited, he took to drinking spirits, became dropsical, ai?d died. I was not permitted to open his body; but, having tapped him two or three times, I felt, on the evacuation of the fluid, a mass ?f hard substance in the loins, which I considered as indurated absorbent glands. 1 was assured by this person, that, after the removal the testicles, he had occasional erections, not unaccompanied with desire, and which when, as a married man, he indulged, were attended with the usual paroxysm and emission of some fluid; and which, from liis description of its colour, consistence, and other properties, I could not doubt came from the vesiculaj seminales. We have in this case a proof of lluid, in the absence of the testicles, having been secreted, evacuated, and repeatedly renewed, in and by the vcsicuhe seminales." It is certain, however, that, although the above lact proves paragraph, as conveying fully our author's sentiments on the subject. He does not seem to have been aware, however, of the more recent mode of operating for the extraction of the stone, proposed by Mr. Sanson, and acted upon so successfully by Professor Vacca, of Pisa, whose interesting memoir on this subject we reviewed in our last Number. " It has often been a disputed point, whether opening into the bladder above the pubes, or from the perineum, is to be preferred in extracting the stone: men of equal experience and celebrity have exclusively adopted each of these operations, but some have practised both; and each, under common circumstances taken on an average, appears to have been attended with nearly the same ratio of success.
Cases, however, may and do occur, where the magnitude of the stone "will call exclusively for the high operation, or that above the pubes." Well known to every individual practising surgery, as they often lead to the formation of, or exist with, other diseases requiring surgical, or even manual, treatment for their cure.
The disposition in the kidney to separate albumen from the blood, is sometimes chronic, at other times only accidental.
When of long duration, it is generally accompanied by great ?notability and a frequent desire to pass the urine. The danger attending this morbid secretion of albumen depends on its intensity and length of duration. When moderate, it has lasted lor years without much injury to the constitution; but, when both permanent and excessive, it indicates a great derangement of the animal economy.
How this disposition to separate albumen from the blood in the kidney is to be counteracted, Mr. Wilson admits that we kn ow not.
Dr. Blackall has recommended bleeding: Mr.
Wilson has seen instances in which the muriated tincture of iron proved very useful in lessening, and he believes in removing, the complaint.
An excess of urea is another form of morbid alteration in Urine, it is commonly found in the urine of children, and in people depositing phosphates. The urine, under these circumstances, is generally pale, reddens litmus paper, and is for the most part free from sediment.
On the addition of nitric acid, ho wever, crystallization speedily takes place, and it is then found to contain an abundant quantity of urea. " When urea is in excess, there is usually a frequent and almost irresistible desire of voiding the urine: this does not arise from theful-438 Critical Analysis. ncss of the bladder, for, in general, a small quantity is voided at any one time; but, from the frequency, the total quantity voided in a given time is greater than natural. This quantity is augmented in cold weather, and is also increased by all causes producing mental agitation. There is also a sense of weight or dull pain in the back, and an occasional irritation about the neck of the bladder, which sometimes extends along the urethra. The pulse, however, is not affected, and the tongue is clcan: there is nO remarkable thirst, nor is there any craving for food, nor are the functions of the stomach and bowels much deranged." Stimulating remedies, observes our author further, particularly opium, byoscyamus, joined to those which may be necessary to keep the stomach and bowels in healthy action, have been found the most efficient in suspending the disease. When the complaint occurs independently of diseases requiring surgical aid, it is to be considered as belonging for its treatment to the province of the physician. The same observation holds good with regard to diabetes, respecting which Mr. Wilson has said but little.
On the subject of hydatids, our readers will find much curious information in the present volume; as also with regard to abscesses formed in the kidneys, and scrofulous affections of these organs. The following specimens will give an idea of the manner in which this part of the work is treated.
The true hydatid is found, in general, in a distinct cyst, which is often of a large size, and composed of firm materials ; so that in some glands, as in the liver, it frequently appears, and to the touch feels, like cartilage. In the kidney, the cyst containing the hydatids is generally thinner than in the liver; but the thickness is different in different parts of the same cyst, and, when cut into, the cyst appears laminated : the laminae arc white, and on the inside they arc lined by a pulpy substance like coagulable lymph. The cavity of the cyst is sometimes subdivided by a portion of this pulpy substance. Within this cyst there is sometimes one hydatid, but oftencr a very considerable number: some of these are attached to the side of the cyst, others arc loose in the cavity and swimming in a fluid. Each hydatid consists of a round bag, composed of a pulpy semi.opaque substance, generally of a whitish, though sometimes of a light amber, colour, and containing a fluid capable of coagulation, although in a less degree than serum.
I have found the fluid coagulate by heat, and become very turbid by the addition of acids." <? Some years ago, in opening a body, in the theatre in Windmillstreet, of an adult man, 1 found a cyst in the liver, containing an immense number of hydatids. A small part of the cyst reached the surface of the liver, on which something like a cicatrix appeared, as if the coat had formerly burst and afterwards united. Another cyst was found in the lower part of the pelvis of the same man, between the rectum and bladder. In the inside of this cyst a white earthy 6ub? stance was found adhering to parts of it, and the wholo was lined with a substance, which, though thicker and more opaque than hydatids even of the largest size usually arc, seemed to be one. When opened, ?'s coats were readily divisible into two lamina?; and a large quantity ?f a whitish substance, divided into lobes, was found adhering to an extensive portion of its inner surface, somewhat resembling a placenta of four or five months and its membranes : as I now producc the preparation, the audience may judge of the similarity. Many small and some very minute hydatids were, and arc still, seen firmly attached to the inner surface of this larger one: hundreds of various sizes were loose in its cavity, some of which still remain there, and the others T have preserved in a separate bottle. Many of these contained smaller hydatids within them. As none of the contents of the pclvi3 were diseased, it appeared to me that the cyst in the pelvis had been formed in conscquencc of some hydatid having, from a rupture of the original cyst in the liver, escaped at the part where the cicatrix appeared, and which had descended so as to reach the most depending part of the cavity formed by the peritoneum : bejng a living animal, it had there increased in size, and produced others ; and, adhering to the parts in its immediate vicinity, it had stimulated the peritoneum to throw out that matter which had formed a cyst, and confined it between the rectum and bladder. This case, I conccive, add9 a little to the probability of the hydatid being a living animal. Long after I had expressed this opinion, in writing the catalogue of my preparations in the museum of Windmill-street, I read, in Dr. John Hunter's paper, that he had the same idea of hydatids bursting from a too-crowded sac, escaping and forming another sac, iu which they propagated others of their own kind." There are no peculiar symptoms by which the first formation of hydatids in the kidneys is marked: pain, in cases where they were afterwards known to exist, has been felt in the loins ; and there also have been nausea, vomiting, and symptomatic fever; but these symptoms belong likewise to other diseases. The existence of hydatids is first ascertained by their having descended through the ureter into the bladder, and from thence having passed through the urethra with the urine. We attended a lady of high rank, last year, who, after every severe attack of nephritic pain, of the most acute kind, requiring the hot-bath and bleeding, passed small, oblong, and transparent membranaceous bags with her urine, accompanied with great irritation of the urethra. She recovered under the internal use the tinctura lyttae. Dr. Scudainore had been in the habit of prescribing for this patient for a supposed gouty diathesis.
With regard to inflammation of the kidneys and scrofulous abscesses, we quote the following passage and case from our author, as particularly in point: ec When active inflammation is going on in the kidney, more or less No, 2?3.
3 R 4Q0 Critical Analysis* pain, according to its extent and progress, is felt in the loins, and the pain occasionally shoots downwards in the direction of the ureters. It is generally attended with a sensation of numbness in the thigh of the afl'ected side; the testicle of that side is also drawn towards the outer ring, and often becomes painful. In phlegmonous inflammation, these last symptoms more frequently occur than in scrofulous; and, when taken with the general habit of the patient, will aid us in discriminating between phlegmonous and scrofulous action. The urine also in the first is usually of a deep-red colour; and in the last it is much paler. I have before stated, that there is much sympathy between the primae viai and the kidneys; so that, when the last arc inflamed, from the stomach sympathizing, sickness and vomiting are produced; and, from the bowels also sympathizing, costiveness comes on, attended with frequent and often violent colicky pains. More or less symptomatic fever is present, depending on the extent of the disease and constitution of the patient. The pus which is formed generally comcs away with the urine. These cases are most usually fatal in their termination, the patient being gradually worn out by the irritation and drain; but they arc not always so. I have known an instance where there was every reason, from local symptoms, to suppose that scrofulous suppuration of the kidney had taken place, where the patient had scrofulous glands in almost every part of the body, and where pus was discharged with the uriue for nearly three years: the patient, soon after the period of puberty, recovered, and is now alive and strong. He never passed any calculus, nor has he one symptom left of the kidney having been diseased. This patient was treated as those usually arc where scrofula prevails: sarsaparilla, bark, and cicuta, were occasionally given; to which, for nearly threemonths, liquor potassce was added, in very moderate doses, and during its exhibition the patient began to recover. " I examined the body of a youth, who died at sixteen years of age, of a very scrofulous habit, and whose spine had become carious. This person had been confined to a horizontal posture for nearly three years, and had passed but little urine through the urethra for many months, and none for several weeks, preceding his death. Abscesses had formed in both kidneys; the ureters were completely closed by scrofulous matters ; and sinuses from the kidney led to the lower part of the loins, and opened on the nates and outer part of the thigh: through these openings the urine, which was not deficient in quantity, ?was constantly discharged. By means of sctons, these openings were at last healed, and .one was made at a more convenient part in the loins, through which the urine of both kidneys continued to discharge until his death. The kidneys were nearly changed into capsules, surrounding cavities lined with the pulpy substance; but each had a small part left of the cortical portion near the upper extremity. The ureters were plugged up with scrofulous matter, and the bladder was contracted, but every where lined by a similar substance. The urethra was small, but in a perfectly natural state." Suppression and Retention of Urine. (Lecture xi.)?In this Mr. Wilson on the Urinary and Genital Organs. 4Q1 kcture are treated many important points of medical and surgical practice,?such as ischuria renalis; retention from inflammation of the bladder, and its treatment; effects of retention ; bursting of the urethra; retention from paralysis; constitutional treatment of retention of urine.
Knowing how absurd it is to expect that students should acquire a knowledge of the mode of introducing the catheter from a mere description of that operation, Mr. Wilson very properly abstains from giving any particular rules for that purpose: still the very judicious reflections which he has made on this delicate point of surgical practice, will and ought to be read with attention by all those who are not insensible to the necessity of becoming properly qualified for the performance of every duty incidental to their profession. ulceration of the bladder; abscesses of the bladder; cj'sts of the bladder; herniaj of the bladder ; fungous excrescences of ditto; scirrhus of the bladder; diseases of the prostate gland; inflammation of the prostate gland; suppuration of ditto; inflammation of the gland from scrofula; scirrhus of the prostate gland, and its causes, with its appearances on dissection; lateral enlargement of the prostate gland; enlargement of the third Tobe; symptoms of scirrhous prostate gland ; symptoms when accompanied by calculi in the bladder; treatment of scirrhous prostate gland ; prostatic calculi; symptoms of ditto; treatment of ditto; irritation of the caput gallinaginis ; treatment of ditto; strictures of the urethra; spasmodic stricture; permanent stricture; situation of strictures; causcs of strictures.
Towards the conclusion of his thirteenth Lecture, Mr. Wilson notices a peculiar disease incidental to women. I have been consulted in some instances where a vascular structure, very similar to that which 1 have now described, has taken place round the external meatus nrinarius in females, and which has been attended with the most exquisite sensibility, so that the passage of the urine was always productive of very great pain, and any external pressure could hardly be borne. In two instances, the vascular sur. face was destroyed by the repeated application of lunar caustic, and which procured much relief; and I believe in both cases the disease is now removed. In a third case, where I was desired by Mr, Clarke to meet him in consultation, he removed the whole of the vascular surface surrounding the meatus urinarius with the knife; and the patient, v/ho was a lady of about twenty years of zgc} pcifcetly lccovered, 492 Critical Analysis. The sensibility of the nerves seems in these cases to be augmented in a greater proportion than the vascularity of the part is increased." We have treated two such cases successfully, without the apparatus for an operation, by the application of the sulphate of copper only.
We wish we had room to dilate on what Mr. Wilson has said respecting strictures of the urethra. Our readers will find this part of the work highly deserving of commendation, and fully instructive. Mr. Wilson has steered clear of all controversies in a discussion which has lately given rise to so many; and, we may add, without having neglected, in any way, the interest of his readers, to whom he has opened, in the most unreserved manner, the store of his valuable information.
Mr. Wilson adds the weight of his testimony to that of Sir E. Home, in favour of the use of caustic for the cure of strictures; although he is decidedly of opinion that its use should be confined to those cases only which will not yield to the introduction of bougies, or which require a portion of the stricture to be destroyed.
The following cases will be read with great interest: " 1 applied the argentum nitratum to a stricture which had becu of long standing in the urethra of a physician, who afterwards was jolted all day over the rough pavement in his carriage, and went four miles into the country to sleep: in the evening an hemorrhage took placc, when I was sent for, with the usual entreaty to come immediately, as he was bleeding to death. I found the family in great alarm, for every drop of the blood had been received on linen ; and the patient, from various means that had been tried to stop the bleeding, had not been allowed a minute's rest. By keeping him still for ten minutes in a horizontal position, the hemorrhage stopped, and two days afterwards the largest-sized bougie passed with case; and, until his death, which happened inRussia several years afterwards, he had no return of thcstricturc." (t A gentleman, about seventy years of age, whose life had been for many years rendered miserable by a stricture, and whose prostate gland was beginning to enlarge, had the lunar caustic applied to the stricture, by a naval medical officer of the highest rank. Soon afterwards, a complete retention of urine took place; the cathcter refused to pass the stricture: the patient became completely insensible, his pulse was failing, and he appeared to be sinking most rapidly to death. I was, at this period, desired to sec him, aud urged by his nearest relatives to attempt the introduction of the catheter. I fortunately succeeded, and drew off more than a quart of urine ; but, from the patient's state, little or no hopes of his recovery were entertained. On seeing him in the evening, his senses were restored, and he was in every respect better, but had passed no urine. The urine was again drawn off, and amounted to a quart: he was still better next morning, but it was ncccssary that the catheter should be again used, and also in the evening of that day. On the morning after this, on withdrawing the catheter, a large slough adhered to it From this time he be gan to pass the urine naturally, but the catlictcr was introduced every night, until the bladder recovered its tone. It is now four years since tiie catheter has been used ; during which period, considering his age, he has enjoyed good health. In this case, although the application of the caustic had occasioned the most alarming symptoms, in the result it has been the means of giving the patient a lite of ease and comfort." u A gentleman, who resided at Barbadoes, of which island he was a native, suffered so much from a stricture in the urethra, that, during the whole period of his passage to England, he had not quitted a chair, that was pierced and prepared to receive his urine, which came drop by drop from the urethra, and with great pain, for more than one bour out of the twenty-four: he was, in fact, obliged to sleep while sitting in this chair. On his arrival in London, the caustic was twice introduced by a surgeon of great eminence j but, on the second introduction, it was squeezed from the bougie, and left in the urethra: a fistula in perinajo was the consequence, and the stricture still remained. He quarrelled with the surgeon who first attended him, and placed himself under my care, without telling me what had produced the fistula; but he strongly urged that the caustic should be again tried.
I observed that he always narrowly watched the caustic bougie, when withdrawn, to examine whether any of the caustic remained in it. I was then in the habit of arming the bougies myself with a small portion of the argentum nitratum. On the seventeenth application, he found the bougie came out without the caustic: he then informed me of what formerly had happened, and gave himself up as lost. Knowing that a very small portion of caustic had been introduced, although not comfortable about the probable event, I did not feel so much alarm. No inconvenience whatever followed the accident. Next morning, his water ilowed freely ; and, four days afterwards, a fullsized bougie went on to the bladder without impediment: the fistula in perinseo soon healed; and, six weeks afterwards, he returned to Ijarbadoes, where he married, and became the father of four children.
He has since called upon me, having made a second voyage to England, and was then perfectly free from his former most distressing complaint." Mr. Wilson has noticed Mr. (Sir) Astley Cooper's method of restoring lost portions of the urethra, by following the plan adopted in India for the restoration of noses and lips. We were Present at the Royal Society last winter, when a paper of Mr. -H. Earle Avas read, giving an account of his very important method of cicatrizing a fistulous sore of the urethra, where a considerable portion of that canal had been destroyed by disease.
The last observations contained in this lecture 1 elate to the retention of calculi in the urethra, and to the mode of puncturing the bladder. We quote a case in which this latter operalion was performed through the perineum by the author, and which proved fatal. 49h Critical Analysis. " In a ease which camc under my own observation, where a complete retention hail taken place from an enlarged prostate gland, and which admitted a catheter to be passed as far as that body, it was thought right to puncture the bladder from the perineum: the patient was placcd in the attitude in which the lateral operation of lithotomy is performed, but complained much of the position and restraint. A catheter was passed to the beginning of the prostate gland, and an incision made on the left side of the raphe of the perineum, of about an inch and a half in length, and sufficiently deep to allow the enlarged prostate to be felt. The finger of the operator was then introduced into the rectum, and the situation of the gland and bladder towards the gut ascertained. Potcau's curved trochar was then introduced into the wound, and conveyed on the left side, but towards the fore part of the enlarged prostate, as near as possiblo. to the bladder ; it was then pushed on, and the stilette withdrawn : about a pint and a half of urine followed, and the patient almost immediately fell asleep. The canula was left in the wound for four days, when, from the irrif tation it produced, it was withdrawn. Some urine having passed by the penis, a flexible gum catheter was introduced into the urethra, and, with a little difficulty, passed on to the bladder: it was allowed to remain there so long as the patient lived, which was above five days after its introduction, and nine from the first operation. The wound in the perineum showed no disposition to heal, but otherwise the operation at first promised a favourable result: the patient was, however, too debilitated for any permanent good to be derived from it. On dissection, it was found that the trochar had entered the cavity of the bladder, a little to the fore, part and left side of the meatus urinarius: it had passed through a small lateral projection of the left lobe of the gland ; but that circumstance did not seem to have had any share in the person's death, as no mark of increased inflammation had taken place round the opening. The great corpulence of the patient, and the projection of the gland backwards towards the gut, were what determined the place of the puncture, added to the greater safety that it ?was supposed the patient would derive from the urine passing by the perineum, should the wound not heal, or should it have been nc? ccssary to keep it open.'' Diseases of the Testicles; Impotency. Conclusion. (Lecture xv.)?The first affection mentioned in this lecture, if it can be called such, is the retarded descent of the testicle or testicles. The cause of this failure in the descent of the testes is not easy to be ascertained : one of them will often remain for months, ?nay, for years,?within the cavity of the abdomen, or playing about the ring. In the latter position, it exposes the person to some risk of inflammation. Where botli have remained in the cavity of the abdomen, it has been supposed by John Hunter that they are exceedingly imperfect, and incapable of performing their natural functions. Mr, Wilson relates two cases, one ot which "seems to confirm this remark, while the other makes rather against it." It is now exactly fifteen years since the Society, of whose Transactions we announce the eleventh volume, first entered upon the discharge of those important duties Avhicli the distinguished founders originally imposed upon themselves, with the laudable intention of promoting the advancement of medical science; and we question whether any other Institution of the same kind has, in so short a period, done more towards attaining that desirable object. Undoubtedly, papers of a very inferior description, or of little intrinsic value, have now and then been admitted among those of a different class in the Transactions, (and of this we have one or two examples again in the present volume;) but, on the whole, we are satisfied that the general voice among the practitioners in the healing art, whether at home or abroad, is wholly favourable to the Society, and expressive of commendation for their exertions.
The present volume contains nineteen memoirs and two appendices, of various degrees of merit and importance. Some are important for the novelty of the subjects of which they treat; others, for the interesting manner in which subjects already familiar to the profession are again brought forward; and some, again, there are which lack both these qualifications. In this last class we hesitate not to place Dr. George Gregory's papers : the first, on Scrofulous Inflammation of the Peritoneum, or Marasmus (as he says it is denominated), in children; the second, on a Malformation of the Heart; and a third, on Chorea treated by Arsenic. Indeed, so different are these three memoirs from the rest of those contained in the volume, and from the generality of those usually admitted in the Transactions,?
and so well do we know the judicious scrupulosity used by the council in the selection of papers for the press,?that we strongly suspect Dr. George Gregory's papers to have found their way into the present volume through some blunder or inadvertency. The sound judgment of those who compose the administration of the Society,?the sense of discrimination which is well known to belong to those who take the lead in it,?and the general satisfaction they have given while in office, authorize us to entertain the above doubt, and to believe that most of them must have been equally surprised with ourselves at the appearance of these said three papers in the present volume. After all, we may be mistaken in our surmise; but, until some one shall have undertaken to prove that the conception which wc have formed of the merits of Dr. G. Gregory's papers, and which we are about to submit to our readers, is erroneous, we shall I continue, in charity to the council, to think that the papers in question can scarcely have got into the volume by genuine importation.
Dr. George Gregory's first paper is thus entitled,?
Observations on the Scrofulous Inflammation of the Peritoneum occurring in Children, and frequently denominated Marasmus. By George Gregory, m.d. senior Physician of the St. George's anil St. James's Dispensary.
Dr. G. G. begins by asserting, that cc the terms marasmus, infantile fever, and diseased mesenteric glands, have long been employed to designate a disease of the abdominal cavity, to which children are subject." This is to us, and we dare say to 4<J 8 Critical Analysis. Dr. Gregory says that he has been able " to distinguish three different states of abdominal disease in children, which have, as a common character, fever of a slow remitting kind, and a general wasting of the body. The first of these consists in simple disturbance of the functions of the intestinal canal without organic derangement." This discovery was made by several authors before Dr. G. Gregory hit upon it. Indeed, he himself quotes Dr. Pemberton as one of those who have been equally lucky with himself in making the discovery. " The second form of marasmus is that in which the mucous membrane of the bowels is extensively implicated." Dr. George Gregory means enteritis, of course. We need not ask our readers whether the author is entitled to the merit of having first ascertained this second form of abdominal affection in children.
The third form, Dr. G. Gregory goes on to state, is primarily " a disease of the peritonaeum and?
" In my views of the pathology of marasmus, I have omitted any particular notice of the mesenteric glands. I have done so, not because I distrust the observations of those authors who have spoken of such a disease, but, first, because, in the various dissections which I have made with the hope of elucidating this subject, I have never once met with any disease of the mesenteric glands which was not complicated with, and probably referable to, a diseased state of the mucous or serous membrane of the abdomen ; and, secondly, because in many of those cases which were seen by other practitioners, and denominated disease of the mesenteric glands, I had an opportunity of proving, by dissection, that those glands were only slightly affected, so as to be scarcely noticed in comparison with the extent of disease present in one or other or both of those membranes." If this means any thing, it means that children are liable to peritonitis. We have no other book by us just now to refer to but Burns's; and we find that this author has had the good fortune to anticipate Dr. G. Gregory, for, at page 593 of the fourth edition, we find a whole chapter on peritonitis, " as a complaint not uncommon with children." Thus, of the " three different states of abdominal disease in children" which Dr. G. G. has been " enabled to ascertain," there is not one which had not been fully ascertained before.
It is worthy of remark, that Dr. G. Gregory, after having condemned authors in general for using three different denominations to designate " a disease of the abdominal cavity in children," uses but one word himself, " marasmus," to designate the " three different states of abdominal diseases he has been able to ascertain!" For, in speaking of the first state, (page 26'.,) he says, the " marasmus was here owing," &c. ; the next he calls " the second form of marasmus;" and the Medico-Chirurgical Transactions : Vol. xi. Part 11. 499 last lie entitles, " the third form of marasmus:v?the one intended to mean " simple disturbance of the intestinal canal "without organic derangementthe second, to mean " ulcerations both of the great and small intestines and the third, to mean " a primary disease of the peritonaeum:" all which significations will be admitted to be pretty extensive when applied to the puny word te marasmus," originally meant to imply simply a wasting of the body, or emaciation ! En passant, we may beg to ask Dr. G. Gregory, whose opportunities for dissections have been numerous, 110  The pith and matter of the first of these two memoirs is positively and wholly concentrated in these few lines: " The lungs were founil adhering every where very firmly to the pleura costalis and pericardium. Tuberclcs and vomica; were scattered through their substance. The cavity of the pericardium contained four ounces of scrum. The heart was very firm, and of a natural size. The aorta and pulmonary artery arose from the right vcntriclc. The septum vcntriculorum, at its base, was wanting for an extent somewhat larger than the diameter of the aorta. The pulmonary artery was not much smaller than natural, and at its origin was surrounded by some cartilaginous-like fibres, between which and the semilunar valve a small sac was formed/' Dr. G. Gregory's merit in this case consists in having been an accidental spectator to a dissection which took place at the Hospital of Saint Pierre, at Bruxelles, in 1817. Not so with regard to the second case, which forms the subject of the third and last paper from Dr. G. Gregory's prolific pen. Here the author had the good fortune of treating suceessfully a case of chorea, in a girl seven years of age, by arsenic, giving the liquor in doses of three drops, gradually increased to seven, three times y-day. Mr. Salter had done so before him in four instances, as it appears from the tenth volume of the Medico-Chirurgical Transactions: and this fact Dr. G. Gregory himself acknowledges; but he forgets to add, that even Mr. Salter hud not been 4 500 -Critical Analysis.
the first publicly to acknowledge the benefit to be derived from arsenic in the treatment of chorea, for he imitated Mr. Martin, who several }'ears before had read a similar case of chorea, successfully treated bj-that medicine, before the same Society: so that the practice, as far as it goes, had already a tolerable share of authority for its support, before Dr. G. Gregory gave us his solitary' case.
We now proceed to a more congenial and a more pleasing task, rfeorettin? that the narrow limits of our Number will not permit us to do justice to the other very valuable papers contained in the present volume. the left than to the right side of the neck, the lobe of the thyroid gland being most enlarged, and the disease occasioning pain and uneasiness i:i the left ear; without, however, impeding deglutition or respiration. Mr. Hutchison passed a Jong and narrow seton needle, armed with half a skain of silk thread, obliquely through the substance of the gland from the left lobe upward, leaving a space of nearly two inches between the entrance and escape of the instrument. A trifling hemorrhage succeeded the operation, but not such as to create the least anxiety. A few days after the operation, a slight degree of erysipelatous inflammation supervened, which was followed by a profuse discharge of a thin acrid matter. As soon as the inflammatory action subsided, the discharge was kept up by occasionally besmearing the seton with savine ointment. On the 5th of December, a fresh seton was applied in an opposite direction. During the following inclement season, the poor woman was attacked with fever, but recovered; and, the tumor gradually diminishing under the action of the discharge, which continued notwithstanding the accidental removal of the seton, she was ultimately discharged cured. The disease is scarcely perceptible, the patient is well, and the skin which covers the tumor of its natural colour.
Mcdico-Chirnrgkd Transactions: Vol. xi. Part n. 501 Mr. Hutchison thinks that the operation by seton in cases of bronchocele is not to be considered as dangerous ; but, in irritable habits, and in the hard tabulated species of the disease, he cautions practitioners to weigh well the necessity of such an operation before they attempt to perform it.
The writer next proceeds to give some instructions respecting the employment of setons in bronchocele, and states his own views with regard to the manner in which the cure of that disease, by means of the operation in question, is effected. On the subject of the probable causes of bronchocele, Mr. Hutchison, instead of wasting his time in idle conjectures, or in a mere compilation of what others have fancied on the subject, very properly observes, that, " before we can reasonably expect to arrive at the causes of the diseased structure, our inquiries should be first directed to obtain a knowledge of the functions of the gland itself, which are at present involved in mystery." The paper concludes with notes on a case of bronchocele A lady was overturned in a coach which had fallen several feet from the road side, three gentlemen, likewise passengers, falling on her at the same time, so that the pubis was forced against the seat. She waslyingin bed, incapable of motion, when theauthor saw her, and the least jar of the bedstead, or a quick and heavy movement across the room, increased her sufferings so much that she screamed out from exquisite pain. Upon examining her, Mr. Coates found but little tension of the pubis; but, on moving the left lower extremity, he could distinctly feel, and even hear, a crepitus. The fracture was situated at the junction of the ramus of the pubis with the ischium. Mr. Coates had a bandage constructed of wide woollen girth web, with buckles and straps placed closelj, which was drawn under the pelvis, as the patient could not be moved, by means of picces of tape attached to bandages, which were insinuated by a plate of elastic steel, and then buckled as tight as could be borne; with directions to tighten it still more, as the bandage should stretch. " Two straps from the back part were passed between the thighs, and buckled to the anterior portion of the belt, to retain it in its situation. Pads were also placed on cach side the pubis. Notwithstand-i0'2 Critical Analysis. ing all the precaution and gentleness used, several severe spasms occurred, which displaced the fractured bones, with great increase of pain. 1 directed that her diet should be of the lowest description ; and, in the event of any recurrence of pain or tension of the abdomen, ihat she should be immediately bled. She was also to take some antimony in saline mixture, and an opiate when necessary." After an interval of between five and six weeks, she was able to walk about with assistance, and eventually recovered, VI. Case of Sudden Death, in which a Hydatid was found in the Substance of the Heart. By Dayid Price, Esq. Communicated in a Letter to the President.
A boy, ten years of age, a pauper, who had never given any signs of being affected by the complaint of which he ultimately died, fell suddenly one day on the pavement, after having been exposed to the splashing of cold water on his naked body, and expired. Mr. Price examined the body, and found in the muscular substance of the heart a large hydatid. In the pericardium there were two ounces of a dark-coloured fluid \ the jrest of the viscera appeared to be health}*. This paper is illustrated by a plate representing a man having an aneurysmal tumor of the carotid artery, the largest, Mr. Coates believes, to which a -ligature has been applied in this country. The patient did not eventually recover; but the author thinks he Jived long enough to prove the success of the operation, and, under this impression, he considers the case as highly instructive. We must quote the author's own account of the operation.
Afedico-Chirurgical Transactions: Vol. xi. Part n. 503 " The sheath of the artery being opened, a moderately-sized ligature of waxed thread was passed under it, by an aneurismal needle, and t'ed. The pulsation in the tumor instantly ceased, and the patient grew faint, but he soon recovered. The wound was drawn together by straps of adhesive plaster, and he was placed in bed. lie, however, continued faint for some minutes, but afterwards became composed.
Scarcely an ounce of blood was lost during the operation. He was ordered to take some gruel." The operation was performed on the 3d of January, and the patient did not die till the 15th of March, and then, apparently, from other causes. The insertion of these two papers from the same hand, in the present volume, might, we think, have been spared. Dr.
Fleming, in his catalogue of Indian plants, had observed that the decoction of the bark of the pomegranate tree was an efficacious remedy for the removal of the tape-worm. Mr. Breton tried.this medicine in eight cases of taenia, in which he administered either the dry powder or the decoction, with an equal success. > As for the pretended substitute for cinchona in the swietenia febrifuga, we shall be glad to find that subsequent experience confirms the reported success which the author has obtained in the treatment of remittent and intermittent fevers by means of that bark.
Our readers will not lose sight of the fact, that the above Paper, and documents annexed to it* were transmitted to the Society through a commercial house, with specimens of the medicine in quill, powder, andextract; and with a notice that a cargo or two of it had arrived in England, and was ready for sate.
X. On the Physiology of the Ear. By JosEru Swan, Esq. of Lincoln.
In a former communication to the Society, Mr. Swan had endeavoured to prove that, when the meatus auditorius externus is stopped, and a sounding body is applied to the lace, sound is ct not mechanically conveyed to the portio mollis of the seventh pair of nerves; and, likewise, that it was probable that in fishes the sense of hearing was produced from the nerves spread on the external parts of the head receiving the impiessions of sound, and conveying them to the auditory nerves; and that man might hear well in this way, when the mechanism by which sound is usually conveyed to the auditory nerves was imperfect." Mr. Swan then supposed " that people born deaf and dumb, and who had no defect in the auditory nerves, might be made to hear through the medium of the facial nerves, and thus have their unfortunate condition in some measure ameliorated.
1 judged that this might be done," says he, " from having observed that dumb people could hear a watch when in contact with the face; and likewise from a case, then related, of a musician, who was enabled to play by having part of the instrument between his teeth." But, as to making the dumb understand the various sounds, and thereby enabling them to speak, the author could urge nothing more than probability. An opportunity has, however, since occurred to Mr. Swan of putting his conjectures on this point to the test of experience ; and it is the objcct of his paper to show, by the relation of that case, that what he thought only probable is really practicable.